Ligating instrument and methods of ligating tissue in endoscopic operative procedures

Abstract

A ligating instrument includes a handle for securing a proximal end of a ligating device externally of the body with one hand, the ligating device defining a lumen for passage therethrough of a length of ligature material formed with a ligature loop for being disposed externally of a distal end of the ligating device to be positioned around anatomical tissue to be ligated within the body, and an operating member coupled with the ligature material for being manually moved with the same hand as that securing the ligating device proximal end to pull the ligature material through the ligating device to form a ligature with the ligature loop in the anatomical tissue. A method of ligating tissue in endoscopic operative procedures includes the steps of securing a proximal end of a ligating instrument externally of the body with one hand, introducing a distal end of the ligating instrument at a surgical site in the body through a portal formed in tissue of the body, placing a length of ligature material carried by the ligating instrument around anatomical tissue to be ligated, moving an operating member of the ligating instrument with the same hand as that securing the proximal end to pull the ligature material through the ligating instrument to tighten the ligature material around the anatomical tissue to form a ligature and actuating a cutter of the ligating instrument to cut the ligature material away from the ligature.

What is claimed is: 
     
       1. A ligating instrument for ligating anatomical tissue comprising a ligating device including an elongate body having a distal end and a proximal end and a length of ligature material extending through said body and secured to said proximal end, said ligature material being formed into a ligature loop disposed externally of said distal end for being positioned around anatomical tissue to be ligated, said proximal end being separable from the remainder of said body to allow said ligature material to be moved through said ligating device to close said ligature loop around the anatomical tissue; and   an adapter including means for receiving said ligating device, a handle connected with said receiving means for being grasped by a hand of a surgeon and operating means coupled with said receiving means for securing said proximal end of said body, said operating means being movable manually by the hand grasping said handle to move said ligature material through said ligating device to close said ligature loop and form a ligature in the anatomical tissue.   
     
     
       2. The ligating instrument as recited in claim 1 wherein said operating means includes a rotatable operating member for being manually rotated by a finger of the hand grasping said handle. 
     
     
       3. The ligating instrument as recited in claim 2 wherein said rotatable operating member includes a roller. 
     
     
       4. The ligating instrument as recited in claim 3 wherein said roller is manually rotatable in a single direction. 
     
     
       5. The ligating instrument as recited in claim 4 further including means on said roller for preventing rotation of said roller in a direction other than said single direction. 
     
     
       6. The ligating instrument as recited in claim 3 wherein said roller is manually rotatable in clockwise and counterclockwise directions. 
     
     
       7. The ligating instrument as recited in claim 6 wherein said adaptor further includes means for limiting rotational movement of said roller in one of said directions. 
     
     
       8. The ligating instrument as recited in claim 1 wherein said receiving means includes a sleeve. 
     
     
       9. The ligating instrument as recited in claim 8 wherein said sleeve includes means for engaging said ligating device body and said engaging means includes a surface of said sleeve frictionally engaging said ligating device body. 
     
     
       10. The ligating instrument as recited in claim 8 wherein said sleeve includes means for engaging said ligating device body and said engaging means includes a latch. 
     
     
       11. The ligating instrument as recited in claim 1 wherein said handle includes means for further moving said ligature material through said ligating device by the hand grasping said handle to tighten the ligature in anatomical tissue upon formation of the ligature with said operating means. 
     
     
       12. The ligating instrument as recited in claim 1 further including a cutter carried by said receiving means for cutting said ligature material adjacent the ligature and actuating means coupled with said handle for actuating said cutter to cut said ligature material in response to movement of said actuating means by the hand grasping said handle. 
     
     
       13. The ligating instrument as recited in claim 12 wherein said cutter is disposed within said receiving means. 
     
     
       14. The ligating instrument as recited in claim 12 wherein said cutter is disposed around said ligating device. 
     
     
       15. The ligating instrument as recited in claim 12 wherein said ligating device further includes a longitudinal axis and said actuating means includes an actuating member movable longitudinally along said axis. 
     
     
       16. The ligating instrument as recited in claim 12 wherein said ligating device further includes a longitudinal axis and said actuating means includes an actuating member movable in a direction transverse to said axis. 
     
     
       17. The ligating instrument as recited in claim 1 wherein said adaptor further includes means for separating said ligating device proximal end from said remainder of said ligating device body automatically in response to movement of said operating means.